# Beyond Lip Service: A Position Paper to Truly Stimulate Shared Decision‐Making

## TL;DR

This paper argues for better inclusion of nurses in shared decision-making and proposes a five-step plan to make patient-centered care a reality in hospitals.

## Contribution

A novel five-step implementation plan to integrate nurses into shared decision-making processes in healthcare.

## Key findings

- Nurses play an essential but underacknowledged role in inclusive shared decision-making.
- A five-step plan can help embed shared decision-making into daily clinical practice.
- The proposed plan is applicable beyond end-of-life care and across healthcare sectors.

## Abstract

To discuss how shared decision‐making (SDM) is currently practised in hospitals, to highlight the essential—yet often underacknowledged—contribution of nurses to inclusive SDM in life‐prolonging treatment decisions, and to propose a five‐step implementation plan to strengthen the role of patients in the SDM process.

A position paper on current SDM practices.

To take a position, we drew on knowledge gained from six empirical studies conducted by our research group and evaluated these findings in light of the most recent literature.

A five‐step implementation plan to stimulate SDM: (1) Clarify roles, (2) Organisational alignment, (3) Comprehensive training, (4) Tailored implementation plans, and (5) Sustainable integration.

The plan is ambitious, yet it offers a clear and actionable path forward for healthcare organisations and professionals. It provides a concrete opportunity for collaboration to embed SDM in daily clinical practice. Ultimately, our shared objective is to achieve optimal patient outcomes—an aim that unites all stakeholders.

Integrating nurses into SDM processes will enhance the quality of support for treatment decision‐making. However, to realise truly inclusive, high‐quality, patient‐centred care, coordinated action at multiple organisational levels is essential.

The proposed plan is not only relevant to treatment decisions at the end of life in hospital settings, but also presents broader opportunities to advance SDM across healthcare sectors. It offers nurses a clearly defined and meaningful role in SDM and provides a practical blueprint for implementation at all levels of the organisation—transforming long‐standing ambitions into tangible practice.